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Article(id=1324077797978812659, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077716676424398, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202508310, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1755619200000, receivedDateStr=2025-08-20, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614347213, onlineDateStr=2026-11-02, pubDate=1773072000000, pubDateStr=2026-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614347213, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614347213, creator=13701087609, updateTime=1793614347213, updator=13701087609, issue=Issue{id=1324077716676424398, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='5', pageStart='769', pageEnd='960', issueExtLink='null', onlineDate='null', pubDate='1773072000000', pubDateStr='2026-03-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614327830, creator='13701087609', updateTime=1793614418028, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324078095132655884, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077716676424398, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324078095132655885, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077716676424398, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=867, endPage=871, ext={EN=ArticleExt(id=1324077798243053812, articleId=1324077797978812659, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Current status of dental caries in primary and secondary school students in an ethnic minority area of Sichuan and its association with nutritional status, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent Health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the prevalence of dental caries among primary and secondary school students in an ethnic minority region of Sichuan, and to examine the relationship between dental caries and nutritional status, with the aim of providing a foundation for effective prevention and control strategies for dental caries in ethnic minority areas.

Methods

A stratified cluster random sampling method was employed to select 13 899 primary and secondary school students from this ethnic minority region for inclusion in the study. Comprehensive oral and physical examinations were conducted, along with the administration of questionnaires. The χ2 test was utilized to compare differences, while logistic regression analysis was performed to investigate the association between dental caries and nutritional status.

Results

In 2024, the caries rate of primary and secondary school students in an ethnic minority area in Sichuan was 74.17%, and 77.63%, 74.29%, and 57.26% for Tibetans, Qiangs, and Han Chinese, respectively. Statistically significant differences were observed in caries rates based on various factors, including gender (χ2=170.20, P<0.001), ethnicity (χ2=364.64, P<0.001), school segment (χ2=93.77, P<0.001),topography (χ2=675.45, P<0.001), overweight and obesity status (χ2=106.85, P<0.001), as well as daily milk consumption (χ2=22.49, P<0.001) among students. The difference in caries rates among students of different ages was statistically significant (χ2=174.82, P<0.001). Overweight and obesity were protective factors for caries among primary and secondary school students in an ethnic minority area of Sichuan (OR=0.696, 0.587, respectively, both P-values<0.001).

Conclusion

The caries rate of primary and secondary school students in an ethnic minority area in Sichuan is high, and overweight and obesity are closely related to caries. It is recommended that an integrated intervention system addressing “environment-nutrition-behavior” be established to prevent dental caries effectively while safeguarding students’ oral health.

, authors=Qiao-qiao REN1, Ya HUANG2, Ling ZENG3, Fu-yan ZHANG4, Liang ZHOU1, authorsList=Qiao-qiao REN, Ya HUANG, Ling ZENG, Fu-yan ZHANG, Liang ZHOU, authorCompany=null, correspAuthors=Liang ZHOU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324077799258075387, articleId=1324077797978812659, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=四川某少数民族地区中小学生龋患现状及与营养状况的关联, columnId=1228016570031604578, journalTitle=现代预防医学, columnName=儿少卫生与妇幼保健, runingTitle=null, highlight=null, articleAbstract=
目的

分析四川某少数民族地区中小学生龋患现状，探讨龋病与营养状况的关联，为少数民族地区龋患防控提供依据。

方法

采用分层整群随机抽样方法，抽取该少数民族地区13 899名中小学生纳入研究，开展口腔、体格检查和问卷调查，差异性检验运用χ2检验，采用logistic 回归分析探讨龋病与营养状况的关联。

结果

2024年四川某少数民族地区中小学生龋患率为 74.17%，藏、羌、汉族分别为77.63%、74.29%、57.26%；不同性别、民族、学段、地形地貌、超重肥胖情况、每天喝奶频率的学生龋患率差异均有统计学意义(χ2= 170.20、364.64、93.77、675.45、106.85、22.49，P均<0.001)。不同年龄学生龋患率差异有统计学意义（χ2=174.82，P<0.001）；超重、肥胖为四川某少数民族地区中小学生龋病的保护因素（OR=0.696、0.587，P值均<0.001）。

结论

四川某少数民族地区中小学生龋患率较高，超重肥胖与龋病密切相关。建议构建“环境-营养-行为”综合干预体系预防龋齿，保护学生口腔健康。

, authors=任悄悄1, 黄亚2, 曾玲3, 张福艳4, 周亮1, authorsList=任悄悄, 黄亚, 曾玲, 张福艳, 周亮, authorCompany=null, correspAuthors=周亮, authorNote=

任悄悄(1993—)，女，硕士，主管医师，研究方向：学校卫生

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周亮，E-mail:
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任悄悄(1993—)，女，硕士，主管医师，研究方向：学校卫生

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Journal of Clinical Pediatric Dentistry, 2022, 46(5): 51-57., articleTitle=Trends in the prevalence of dental caries in the US pediatric population 2011-2020, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1324077799622979836, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077797978812659, xref=1., ext=[AuthorCompanyExt(id=1324077799635562749, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077797978812659, companyId=1324077799622979836, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Sichuan Provincial Center for Disease Control and Prevention, Chengdu, Sichuan 610041, China), AuthorCompanyExt(id=1324077799652339966, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077797978812659, companyId=1324077799622979836, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.四川省疾病预防控制中心，四川 成都 610041)]), AuthorCompany(id=1324077801363615999, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077797978812659, xref=2., ext=[AuthorCompanyExt(id=1324077801367810304, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077797978812659, companyId=1324077801363615999, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.阿坝州疾病预防控制中心)]), AuthorCompany(id=1324077801455890690, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077797978812659, xref=3., ext=[AuthorCompanyExt(id=1324077801464279300, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077797978812659, companyId=1324077801455890690, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.德阳市疾病预防控制中心)]), AuthorCompany(id=1324077801594302725, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077797978812659, xref=4., ext=[AuthorCompanyExt(id=1324077801606885638, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077797978812659, companyId=1324077801594302725, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4.自贡市疾病预防控制中心)])], figs=[ArticleFig(id=1324077804043776296, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077797978812659, language=EN, label=Figure 1, caption=Caries prevalence among students of different age groups and ethnic groups in an ethnic minority area of Sichuan, figureFileSmall=JPYFXM+hvFX09lPKBluOdw==, figureFileBig=L+1W5+ln/5qSQs6QUiQlaQ==, tableContent=null), ArticleFig(id=1324077804140245289, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077797978812659, language=CN, label=图1, caption=四川某少数民族地区不同年龄段不同民族学生龋患率情况

注:*P<0.001。

, figureFileSmall=JPYFXM+hvFX09lPKBluOdw==, figureFileBig=L+1W5+ln/5qSQs6QUiQlaQ==, tableContent=null), ArticleFig(id=1324077805918630187, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077797978812659, language=EN, label=Table 1, caption=

Detection of dental caries in primary and secondary school students in an ethnic minority area of Sichuan

, figureFileSmall=null, figureFileBig=null, tableContent=
项目调查人数构成比
（%）		龋齿乳牙龋恒牙龋
例数（%）χ2值P值例数（%）χ2值P值例数（%）χ2值P值
性别170.20<0.0014.330.039190.81<0.001
男6 27245.134 317(68.83)1 473(23.49)3 559(56.74)
女7 62754.875 992(78.56)1 678(22.00)5 795(68.11)
民族364.64<0.0012.950.231416.20<0.001
汉族2 03114.611 163(57.26)435(21.42)869(42.79)
羌族1 99914.381 485(74.29)442(22.11)1 323(66.18)
藏族9 86971.017 661(77.63)2 274(23.04)6 562(66.49)
学段93.77<0.00135.58<0.001593.02<0.001
小学5 20437.444 039(77.61)2 729(52.44)2 646(50.85)
初中5 45639.253 806(69.76)386(7.07)3 654(66.97)
高中3 23923.302 464(76.07)36(1.11)2 454(75.76)
地形地貌675.45<0.00141.14<0.001698.48<0.001
东南高山峡谷区8 27359.525 481(66.25)1 760(21.27)4 473(54.07)
中部山原区3 84527.663 261(84.81)888(23.09)2 904(75.52)
西北部高原区1 78112.811 567(87.98)503(28.24)1 377(77.32)
超重肥胖106.85<0.00139.69<0.00182.82<0.001
非超重肥胖11 42882.228 674(75.902 695(23.58)7 373(64.52)
超重1 67212.031 132(67.70279(16.69)982(58.73)
肥胖7995.75503(62.95)177(22.15)399(49.94)
营养不良3.660.05675.45<0.0010.260.612
否12 89092.749 535(73.97)2 811(21.81)8 126(63.04)
是1 0097.26774(76.71)340(33.70)628(62.24)
喝含糖饮料频率8.610.01359.29<0.00126.62<0.001
从来不吃3 07722.142 266(73.64)854(27.75)1 831(59.51)
少于每天一次9 54268.657 050(73.88)2 011(21.08)6 064(63.55)
每天1次及以上1 2809.21993(77.58)286(22.34)859(67.11)
每天喝奶频率22.49<0.00153.33<0.00132.21<0.001
从来不吃1 97914.241 500(75.80)574(29.00)1 263(63.82)
少于每天一次6 79748.905 127(75.43)1 453(21.38)4 418(65.50)
每天1次及以上5 12336.863 682(71.87)1 124(21.94)3 073(59.98)
早晚刷牙5.890.0151.000.31712.29<0.001
否3 44224.762 607(75.74)759(22.05)2 254(65.49)
是10 45775.247 702(73.65)2 392(22.87)6 500(62.16)
), ArticleFig(id=1324077806019293484, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077797978812659, language=CN, label=表1, caption=

四川某少数民族地区中小学生龋齿检出情况

, figureFileSmall=null, figureFileBig=null, tableContent=
项目调查人数构成比
（%）		龋齿乳牙龋恒牙龋
例数（%）χ2值P值例数（%）χ2值P值例数（%）χ2值P值
性别170.20<0.0014.330.039190.81<0.001
男6 27245.134 317(68.83)1 473(23.49)3 559(56.74)
女7 62754.875 992(78.56)1 678(22.00)5 795(68.11)
民族364.64<0.0012.950.231416.20<0.001
汉族2 03114.611 163(57.26)435(21.42)869(42.79)
羌族1 99914.381 485(74.29)442(22.11)1 323(66.18)
藏族9 86971.017 661(77.63)2 274(23.04)6 562(66.49)
学段93.77<0.00135.58<0.001593.02<0.001
小学5 20437.444 039(77.61)2 729(52.44)2 646(50.85)
初中5 45639.253 806(69.76)386(7.07)3 654(66.97)
高中3 23923.302 464(76.07)36(1.11)2 454(75.76)
地形地貌675.45<0.00141.14<0.001698.48<0.001
东南高山峡谷区8 27359.525 481(66.25)1 760(21.27)4 473(54.07)
中部山原区3 84527.663 261(84.81)888(23.09)2 904(75.52)
西北部高原区1 78112.811 567(87.98)503(28.24)1 377(77.32)
超重肥胖106.85<0.00139.69<0.00182.82<0.001
非超重肥胖11 42882.228 674(75.902 695(23.58)7 373(64.52)
超重1 67212.031 132(67.70279(16.69)982(58.73)
肥胖7995.75503(62.95)177(22.15)399(49.94)
营养不良3.660.05675.45<0.0010.260.612
否12 89092.749 535(73.97)2 811(21.81)8 126(63.04)
是1 0097.26774(76.71)340(33.70)628(62.24)
喝含糖饮料频率8.610.01359.29<0.00126.62<0.001
从来不吃3 07722.142 266(73.64)854(27.75)1 831(59.51)
少于每天一次9 54268.657 050(73.88)2 011(21.08)6 064(63.55)
每天1次及以上1 2809.21993(77.58)286(22.34)859(67.11)
每天喝奶频率22.49<0.00153.33<0.00132.21<0.001
从来不吃1 97914.241 500(75.80)574(29.00)1 263(63.82)
少于每天一次6 79748.905 127(75.43)1 453(21.38)4 418(65.50)
每天1次及以上5 12336.863 682(71.87)1 124(21.94)3 073(59.98)
早晚刷牙5.890.0151.000.31712.29<0.001
否3 44224.762 607(75.74)759(22.05)2 254(65.49)
是10 45775.247 702(73.65)2 392(22.87)6 500(62.16)
), ArticleFig(id=1324077806132539693, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077797978812659, language=EN, label=Table 2, caption=

Variable assignment table for behavioral factors related to dental caries among primary and secondary school students in an ethnic minority area in Sichuan

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值
龋齿0=否，1=是
性别1=男，2=女
民族1=汉族，2=藏族，3=羌族
学段1=小学生，2=初中生，3=高中生
地形地貌1=东南高山峡谷区，2=中部山原区，3=西北部高原区
超重肥胖0=非超重肥胖，1=超重，2=肥胖
营养不良0=否，1=是
喝含糖饮料频率1=从来不吃，2=少于每天一次，3=每天1次及以上
每天喝奶类1=从来不吃，2=少于每天一次，3=每天1次及以上
早晚刷牙0=否，1=是
), ArticleFig(id=1324077806245785902, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077797978812659, language=CN, label=表2, caption=

四川某少数民族地区中小学生 龋齿相关行为变量赋值表

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值
龋齿0=否，1=是
性别1=男，2=女
民族1=汉族，2=藏族，3=羌族
学段1=小学生，2=初中生，3=高中生
地形地貌1=东南高山峡谷区，2=中部山原区，3=西北部高原区
超重肥胖0=非超重肥胖，1=超重，2=肥胖
营养不良0=否，1=是
喝含糖饮料频率1=从来不吃，2=少于每天一次，3=每天1次及以上
每天喝奶类1=从来不吃，2=少于每天一次，3=每天1次及以上
早晚刷牙0=否，1=是
), ArticleFig(id=1324077806522609967, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077797978812659, language=EN, label=Table 3, caption=

Association between overweight and obesity and dental caries among students of different ethnic groups in an ethnic minority area of Sichuan

, figureFileSmall=null, figureFileBig=null, tableContent=
自变量选项β P值OR值 (95%CI)
总体
超重肥胖（ref:非超重肥胖）超重-0.3680.059<0.0010.696 （0.620～0.782）
肥胖-0.5460.080<0.0010.587 （0.502～0.687）
藏族
超重肥胖（ref:非超重肥胖）超重-0.3680.075<0.0010.695 （0.600～0.805）
肥胖-0.5160.105<0.0010.602 （0.490～0.741）
羌族
超重肥胖（ref:非超重肥胖）超重-0.2910.1440.0400.744 （0.561～0.986）
肥胖-0.7030.172<0.0010.500 （0.356～0.701）
汉族
超重肥胖（ref:非超重肥胖）超重-0.4670.1350.0010.640 （0.490～0.837）
肥胖-0.5020.1770.0100.630 （0.444～0.894）
), ArticleFig(id=1324077806631661872, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077797978812659, language=CN, label=表3, caption=

四川某少数民族地区不同民族学生超重肥胖与龋齿的关联性分析

, figureFileSmall=null, figureFileBig=null, tableContent=
自变量选项β P值OR值 (95%CI)
总体
超重肥胖（ref:非超重肥胖）超重-0.3680.059<0.0010.696 （0.620～0.782）
肥胖-0.5460.080<0.0010.587 （0.502～0.687）
藏族
超重肥胖（ref:非超重肥胖）超重-0.3680.075<0.0010.695 （0.600～0.805）
肥胖-0.5160.105<0.0010.602 （0.490～0.741）
羌族
超重肥胖（ref:非超重肥胖）超重-0.2910.1440.0400.744 （0.561～0.986）
肥胖-0.7030.172<0.0010.500 （0.356～0.701）
汉族
超重肥胖（ref:非超重肥胖）超重-0.4670.1350.0010.640 （0.490～0.837）
肥胖-0.5020.1770.0100.630 （0.444～0.894）
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四川某少数民族地区中小学生龋患现状及与营养状况的关联
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任悄悄 1 , 黄亚 2 , 曾玲 3 , 张福艳 4 , 周亮 1
现代预防医学 | 儿少卫生与妇幼保健 2026,53(5): 867-871
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现代预防医学 |儿少卫生与妇幼保健 2026 , 53 (5) : 867 -871
四川某少数民族地区中小学生龋患现状及与营养状况的关联
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任悄悄1, 黄亚2, 曾玲3, 张福艳4, 周亮1
作者信息
  • 1.四川省疾病预防控制中心，四川 成都 610041
  • 2.阿坝州疾病预防控制中心
  • 3.德阳市疾病预防控制中心
  • 4.自贡市疾病预防控制中心
通讯作者:
周亮，E-mail:
作者简介:

任悄悄(1993—)，女，硕士，主管医师，研究方向：学校卫生

Current status of dental caries in primary and secondary school students in an ethnic minority area of Sichuan and its association with nutritional status
Qiao-qiao REN1, Ya HUANG2, Ling ZENG3, Fu-yan ZHANG4, Liang ZHOU1
Affiliations
  • Sichuan Provincial Center for Disease Control and Prevention, Chengdu, Sichuan 610041, China
出版时间: 2026-03-10 doi: 10.20043/j.cnki.MPM.202508310
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摘要
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目的

分析四川某少数民族地区中小学生龋患现状，探讨龋病与营养状况的关联，为少数民族地区龋患防控提供依据。

方法

采用分层整群随机抽样方法，抽取该少数民族地区13 899名中小学生纳入研究，开展口腔、体格检查和问卷调查，差异性检验运用χ2检验，采用logistic 回归分析探讨龋病与营养状况的关联。

结果

2024年四川某少数民族地区中小学生龋患率为 74.17%，藏、羌、汉族分别为77.63%、74.29%、57.26%；不同性别、民族、学段、地形地貌、超重肥胖情况、每天喝奶频率的学生龋患率差异均有统计学意义(χ2= 170.20、364.64、93.77、675.45、106.85、22.49，P均<0.001)。不同年龄学生龋患率差异有统计学意义（χ2=174.82，P<0.001）；超重、肥胖为四川某少数民族地区中小学生龋病的保护因素（OR=0.696、0.587，P值均<0.001）。

结论

四川某少数民族地区中小学生龋患率较高，超重肥胖与龋病密切相关。建议构建“环境-营养-行为”综合干预体系预防龋齿，保护学生口腔健康。

龋齿  /  少数民族  /  营养状况  /  学生
Objective

To investigate the prevalence of dental caries among primary and secondary school students in an ethnic minority region of Sichuan, and to examine the relationship between dental caries and nutritional status, with the aim of providing a foundation for effective prevention and control strategies for dental caries in ethnic minority areas.

Methods

A stratified cluster random sampling method was employed to select 13 899 primary and secondary school students from this ethnic minority region for inclusion in the study. Comprehensive oral and physical examinations were conducted, along with the administration of questionnaires. The χ2 test was utilized to compare differences, while logistic regression analysis was performed to investigate the association between dental caries and nutritional status.

Results

In 2024, the caries rate of primary and secondary school students in an ethnic minority area in Sichuan was 74.17%, and 77.63%, 74.29%, and 57.26% for Tibetans, Qiangs, and Han Chinese, respectively. Statistically significant differences were observed in caries rates based on various factors, including gender (χ2=170.20, P<0.001), ethnicity (χ2=364.64, P<0.001), school segment (χ2=93.77, P<0.001),topography (χ2=675.45, P<0.001), overweight and obesity status (χ2=106.85, P<0.001), as well as daily milk consumption (χ2=22.49, P<0.001) among students. The difference in caries rates among students of different ages was statistically significant (χ2=174.82, P<0.001). Overweight and obesity were protective factors for caries among primary and secondary school students in an ethnic minority area of Sichuan (OR=0.696, 0.587, respectively, both P-values<0.001).

Conclusion

The caries rate of primary and secondary school students in an ethnic minority area in Sichuan is high, and overweight and obesity are closely related to caries. It is recommended that an integrated intervention system addressing “environment-nutrition-behavior” be established to prevent dental caries effectively while safeguarding students’ oral health.

Dental caries  /  Ethnic minorities  /  Nutritional status  /  Students
任悄悄, 黄亚, 曾玲, 张福艳, 周亮. 四川某少数民族地区中小学生龋患现状及与营养状况的关联. 现代预防医学, 2026 , 53 (5) : 867 -871 . DOI: 10.20043/j.cnki.MPM.202508310
Qiao-qiao REN, Ya HUANG, Ling ZENG, Fu-yan ZHANG, Liang ZHOU. Current status of dental caries in primary and secondary school students in an ethnic minority area of Sichuan and its association with nutritional status[J]. Modern Preventive Medicine, 2026 , 53 (5) : 867 -871 . DOI: 10.20043/j.cnki.MPM.202508310
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龋病作为儿童青少年口腔健康的首要威胁，影响其身心健康[1]。世界卫生组织报告显示，全球约60%～90%的儿童受龋病困扰[2]。根据我国第三次和第四次全国口腔健康流行病学调查结果来看，我国儿童患龋率在十年中呈上升的趋势[3]。龋病不仅影响咀嚼、消化及吸收功能，还可引发营养不良、胃肠功能紊乱等问题[4-5]，其发生与口腔卫生行为、饮食习惯、社会环境等有关[6]，还与超重肥胖、营养不良等机体状态存在关联[7]。随着经济的快速发展，我国儿童青少年龋病、超重肥胖形式不容乐观，已成为社会关注的公共卫生问题，越来越多的研究聚焦龋病与营养状况的相关性。既往发达国家的调查结果显示龋病与超重肥胖呈正相关，而在欠发达国家进行的龋病和超重肥胖的相关性研究结果尚存在分歧[8]。位于青藏高原东南缘的四川某少数民族地区，平均海拔约3 600米，是以藏、羌族为主的少数民族聚居地。该地区高寒低氧的自然条件、落后的医疗条件使得当地居民在遗传特征、饮食行为等方面形成了鲜明的民族地域特色[9]。目前，我国针对少数民族地区学生龋病、营养状况及其关联的研究仍较为匮乏，因此有必要进一步探究。本调查以该地区藏羌汉三族中小学生为研究对象，探讨龋病与营养状况的关联性,为制定适用于高海拔少数民族地区的龋病防治策略提供科学依据。
1　对象与方法
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1.1　对象
2024年9—11月，设四川某少数民族地区1个市和12个县为监测点，采取分层整群随机抽样方法，按照年级进行分层，每个市随机抽取7所学校(2所小学、2所初中、2所高中、1所职高)，每个县随机抽取5所学校(2所小学、2所初中、1所高中)，在被选取的学校中，小学四至六年级、初中和高中全部年级每个年级随机抽取2个及以上班级，被抽取的班级全体学生开展身高、体重、龋病检查和问卷调查，确保每个年级不少于80人。本研究已通过四川省疾病预防控制中心伦理委员会批准(审批号：SCCDCIRB第 2025-025号），调查均取得学生和家长的知情同意。
1.2　方法
1.2.1　口腔检查
依据《学生健康检查技术规范》（GB/T 26343—2010）[10]要求，由口腔专业医生对调查学生进行龋齿检查，主要检查龋齿的部位及数量，并记录乳、恒牙龋、失、补的情况。龋齿的判定标准为：凡乳、恒牙有龋、失、补任何一种则判定为龋齿，龋、失、补都为零的判定为无龋。
1.2.2　体格检查
按照《学生健康检查技术规范》（GB/T 26343-2010）[10]要求，对学生进行身高、体重测量，计算身体质量指数(body mass index，BMI)BMI=体重(kg)/身高的二次方(m2)。
1.2.3　超重肥胖/营养不良判定标准
依据《学龄儿童青少年超重与肥胖筛查》(WS/T 586—2018)[11]标准判定超重、肥胖情况，当 BMI 大于或等于相应性别、年龄组“超重”界值点时为超重，当 BMI 大于或等于相应性别、年龄组“肥胖”界值点时为肥胖；儿童青少年生长迟缓、轻度消瘦和中度消瘦采用《学龄儿童青少年营养不良筛查》[12]（WS / T 456 —2014）进行判断。营养不良由生长迟缓、轻度消瘦和中度消瘦三者合计得出。
1.2.4　问卷调查
采用学生自填问卷，内容涵盖学生基本情况（性别、民族、年级、出生日期等）、喝含糖饮料频率、每天喝奶频率、每天刷牙习惯等。按照地形地貌不同将该地区划分为东南部高山峡谷区、中部山原区和西北部高原区。问卷由学生现场填写，完成后当场收回并审核，确保问卷规范有效。
1.2.5　质量控制
调查前所有检测人员均经过统一培训，熟练掌握体格和龋齿检查的方法及诊断标准，问卷调查由卫生专业技术人员负责。检查现场均设置质量控制人员，以每天5% 比例随机抽取调查对象进行复测，以确保调查质量。
1.3　统计分析
运用EpiData 3.1建立数据库，采用SPSS 30.0软件对数据进行统计学分析。不同组间龋患率差异性的比较采用χ2检验，使用趋势χ2检验分析龋患率随年龄增长的变化趋势。采用logistic回归分析龋病与不同营养状况的关联，检验水准 α=0.05。
2　结果
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2.1　基本情况
共调查13 899名中小学生，男生6 272名（45.13%），女生7 627名（54.87%）；汉族2 031名（14.61%），羌族1 999名（14.38%），藏族9 869名（71.01%）；小学生5 204名（37.44%），初中生5 456名（39.25%），高中生3 239名（23.30%）。
2.2　龋齿检出结果
13 899名中小学生中患龋学生10 309人，龋患率为 74.17%，藏、羌、汉族龋患率分别为77.63%、74.29%、57.26%。不同性别、民族、学段、地形地貌、超重肥胖情况、喝含糖饮料频率、每天喝奶频率、早晚刷牙情况不同的学生龋患率差异均有统计学意义(P<0.05)。见表1。
分年龄来看，13岁年龄段学生的龋患率最低，为67.55%；9～18岁年龄段藏、羌、汉学生的龋患率差异均有统计学意义( P值均<0.001)。见图1。
2.3　超重肥胖与龋齿的关联
以学生是否患龋（否=0，是=1）为因变量，以超重肥胖情况为自变量进行多因素logistic 回归分析，变量赋值结果见表2。总体结果显示，在控制了性别、民族、地形地貌、喝含糖饮料频率、每天喝奶频率、早晚刷牙因素后，超重、肥胖为四川某少数民族地区中小学生龋病的保护因素（OR=0.696、0.587，P值均<0.001）。见表3。
3　讨论
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龋患率是衡量群体龋齿流行状况及严重程度的核心指标[13-14]。2024年四川某少数民族地区中小学生龋患率达74.17%，高于本省平均水平（47.20%）[15]及全国平均水平（41.90%）[16]，提示该地区龋病问题比较严重。一方面，可能与少数民族地区近些年在国家大力扶持下经济快速增长，饮食逐渐趋向精细化,摄糖量增加的同时龋患率也随之上升有关，这提示少数民族地区的防龋工作需与经济发展节奏相匹配；另一方面，可能与该地区特殊的气候及地理环境相关：高海拔形成的低氧环境可抑制腺体功能，减少唾液分泌，进而降低口腔自洁能力。本调查还显示，汉族学生龋患率低于羌族和藏族。究其原因，可能与当地不同民族的遗传差异、民族风俗及饮食习惯等因素相关[17]。例如，藏族和羌族居民日常饮食以牛羊肉为主，蔬菜摄入量较少，而汉族饮食中富含膳食纤维的蔬菜占比较高，这类粗纤维有助于牙齿自洁，在一定程度上可预防龋病发生。
该地区学生13岁年龄组龋患率最低，这可能与此阶段乳恒牙替换基本完成相关：原有乳牙龋坏随乳牙脱落而消除，新生恒牙尚未累积明显龋损，从而降低了龋病发生风险[6]。而随着青春期到来，生长发育进入突增期，机体对钙、优质蛋白等营养素的需求激增，若摄入相对不足，可能影响牙釉质及本质的正常发育[18]；加之恒牙萌出后随时间推移龋损逐渐累积，共同导致龋患率上升。因此，有必要针对不同年龄段学生的发育特点开展精准化口腔卫生宣教，尤其是低龄学生的龋病预防。
营养是影响儿童青少年生长发育的关键因素[19]。目前，国内外关于龋病与超重肥胖的相关性研究已有较多报道，但结论尚未统一[20-21]。本调查结果显示，超重肥胖学生患龋风险低于非超重肥胖学生，这与国内学者孙桃兰[7]研究结论一致。其可能机制为：超重肥胖学生食物消耗量较大，体内营养素相对充足，对致龋菌的抵抗力增强，从而降低龋病发生概率[1]。
综上所述，四川某少数民族地区学生龋患问题突出，形势严峻，其中少数民族学生的口腔健康状况亟待重点关注，且龋病与营养状况相关，当地政府应构建“环境-营养-行为”综合干预体系，以系统防控学生龋病。本研究不足之处：作为横断面观察设计，仅能揭示变量间的相关性，无法确立因果关系；调查问卷由学生自行填写，可能引入回忆偏倚，影响结果准确性。未来建议开展纵向队列研究，通过长期追踪，进一步明确龋病与营养状况之间的因果关联。

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2026年第53卷第5期
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doi: 10.20043/j.cnki.MPM.202508310
  • 接收时间：2025-08-20
  • 首发时间：2026-11-02
  • 出版时间：2026-03-10
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  • 收稿日期：2025-08-20
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    1.四川省疾病预防控制中心，四川 成都 610041
    2.阿坝州疾病预防控制中心
    3.德阳市疾病预防控制中心
    4.自贡市疾病预防控制中心

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Number of
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Number of
species		 占总种数比例
Percentage of
total species (%)		 属
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
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